Provider Demographics
NPI:1255368452
Name:BRESKY, KENNETH E (DO)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:E
Last Name:BRESKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 ENTERPRISE CTR BOULEVARD, STE 100
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3759
Mailing Address - Country:US
Mailing Address - Phone:561-740-4855
Mailing Address - Fax:561-740-4755
Practice Address - Street 1:10151 ENTERPRISE CTR BOULEVARD, STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3759
Practice Address - Country:US
Practice Address - Phone:561-740-4855
Practice Address - Fax:561-740-4755
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-7434207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254858500Medicaid
FLG83728Medicare UPIN